Date of Award

Fall 2026

Abstract

Background: Stigmatizing attitudes among healthcare providers toward individuals with opioid use disorder (OUD) represent a critical barrier to care, treatment retention, and equitable healthcare utilization.

Local Problem: A primary care practice in Lewiston, Maine, serving a medically underserved region heavily impacted by the opioid crisis. Community Health Needs Assessment identified healthcare provider stigma and treatment access gaps as primary obstacles to OUD in this county.

Methods: Utilizing a Plan-Do-Study-Act (PDSA) quality improvement framework, an asynchronous, multimedia-driven educational curriculum was implemented among primary care clinicians (N = 7 invited; n = 4 completed). A mid-stream pivot from an in-person to asynchronous model was executed to accommodate clinic scheduling constraints. Primary quantitative outcomes were measured using the 15-item Opening Minds Provider Attitudes Toward Opioid Use Scale (OM-PATOS) at baseline and post-intervention and were evaluated via non-parametric effect sizes (rrb, probability of superiority). Secondary outcomes assessed were medication-assisted treatment (MAT) prescribing willingness, clinical confidence, and perceived practice barriers via supplemental survey items.

Interventions: Participants completed two asynchronous modules independently over a two-week period. The curriculum embedded digital lived experience narratives and video resources produced by PBS, Inside Edition, and Know Your Options Maine, alongside targeted high-impact educational resources from NIDA, SAMHSA, and TED Talks.

Results: A 100% completion rate (n = 4) and complete paired datasets were achieved. Overall OM-PATOS scores demonstrated a moderate cohort effect size (r = 0.38, median reduction from 29.00 to 26.50), and a universal directional improvement (100%) across the ‘behaviors and motivations’ to help subscale (rrb = -0.67, PS = 66.7%). High baseline prescribing intentions and active MAT caseloads (1 to 16 patients) were sustained or expanded. Concurrently, total endorsed system-level treatment barriers doubled (from 5 to 10), reflecting heightened clinical self-awareness regarding complex mental health and resource constraints.

Conclusions: An asynchronous, multimedia-driven curriculum integrated lived experience narratives from peers provides a feasible, zero-direct-cost mechanism to enhance provider helping behaviors and deepen commitment to primary care addiction treatment without disrupting clinical workflows.

Keywords: opioid use disorder, primary care, healthcare provider stigma, asynchronous learning, contact-based education, quality improvement

Document Type

Clinical Doctorate

First Advisor

Dayle Sharp

Second Advisor

Matthew Harnden

College or School

School of Nursing

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